County 911 service set for upgrade

"Putnam County 911, what is the address of the emergency? What is the phone number that you are calling from? What is the problem, tell me exactly what happened?"

That is what callers can expect when they call 911 after Aug. 1 when Putnam County 911 begins using Emergency Medical Dispatching (EMD). Although the caller's address and phone number routinely show up during a 911 call, this format allows the dispatch center to verify the correct address and phone number.

EMD is a structured program that uses standardized questions for callers to determine what is wrong with the patient(s), how many resources to send, and whether the resources need to respond emergent (lights and sirens).

"This is a valuable service for the citizens of Putnam County," says Dr. Ed Barkus, Medical Director for Putnam County 911. "The on-line medical directions provided by the specially-trained communications personnel will allow life-saving care to be provided by family or bystanders immediately, and dovetail into basic life support services of the fire departments and the advanced life support services of OL."

The EMD program allows a dispatcher to place a call into trauma or medical call and then specific categories from generic "sick person" to "chest pain" to "breathing difficulty." The dispatcher then has a series of questions they can ask to get key information needed to determine how to dispatch the call.

"Callers need to realize that unlike the current systems of handling telephone calls, the new system will be more structured," says Dave Costin, 911 Director. "It may seem like our dispatchers are asking several questions, but only critical questions will be asked."

Dr. Bartkus agrees, indicating that although it may seem like a lot of questions, generally the ambulance and any first responders will be dispatched early into the call and then the questions may continue as well as any instructions for what to do to help the patient until responders arrive.

Putnam County will be using computerized EMD which will allow the calls to be handled via computer screens which will then bring up related screens and give the dispatchers the information they need to gather information more quickly.

Once the call has been categorized, the prompts will inform the dispatcher what resources to send: advanced live support (paramedic) or basic live support (EMT) ambulance and whether the first responding fire department is needed. The dispatcher will also advise the departments responding whether to respond emergent or not.

"This will be a big improvement and minimize the risk of accidents for responding units to calls," says Kraig Kinney, Putnam County Operation Life Executive Director. "One of the big questions I always get is why so many fire engines and ambulances are sent to calls. This new system will streamline the process and get only the resources that are needed for that particular patient."

Costin and Kinney indicated that even on calls where dispatch only sends one non-emergent ambulance, that ambulance can request additional resources such as the fire department if needed to help locate an address or move the patient.

Besides relying upon the computer prompts, the 911 Center's dispatchers have all been trained (or will be in the next couple of weeks) at a certified Priority Dispatch EMD course.

The course is three 8-hour days and guides the dispatchers through call talking and using the question prompts.

"In the past, we have tried to send our dispatchers through First Responder or EMT training," says Costin. "However, it is sometimes difficult for even a trained dispatcher to collect all the key information from a call. The EMD system promotes uniformity and assures that appropriate questions are asked."

EMD also includes specific instructions to callers that the trained dispatcher can give, from as basic as "lay the person down" to "turn out your porch lights to help them locate you."

"Having standard instructions will make sure all 911 calls of the same type are handled the same regardless of the individual dispatcher and make sure that good pre-arrival instructions are given to help the patient until our ambulances arrive," says Kinney.

The structured EMD system requires quality assurance mechanisms to assure that the standards are being followed.

Costin has set up a review system that includes dispatchers, as well as Operation Life and fire department representation.

The oversight committee also works with Dr. Bartkus who is the Medical Director for the 911 Center as well as Operation Life and most county fire departments.

Costin indicated that during the remainder of 2006, the compliance standards will be more relaxed to allow the dispatchers time to adjust to the new system, but that standards will be tighter by the end of the year.